Professional, Prior Authorization

Professional, Prior Authorization 3.1 3.1 out of 5 stars 500 West Jefferson Street, Louisville, KY 40202 Full-time Advantum Health 97 reviews Full-time Job Summary The Professional, Prior Authorization is a health care professional working to validate the patients' health care benefits and obtain authorization for scheduled procedures and medications. Responsibilities include contacting a patient's insurance company to verify coverage, initiate authorizations, provide clinical documentation, follow up on previously initiated authorizations. Serves as a valued member of the health care team, helping patients get the medical procedures they need. Also responsible for responding to telephone/email inquiries from callers as they relate to health services our customers provide. Qualifications 3-5 years of experience working in a hospital, doctors office, or billing setting Have working knowledge of CPT codes and Diagnostic Codes Working knowledge of co-pay and out of pocket expenses from an insurance perspective 3-5 years procedure and/or medication authorization experience required Microsoft Office Suite (Excel, Word, and Outlook) and Internet Ability to handle confidential and sensitive information Ability to have working knowledge of medical terminology and are familiar with insurance and hospital billing policies and procedures. 5+ years of experience related to initiation/follow-up of Prior Authorizations. 2+ years of experience in the following up of medication and procedure Prior Authorizations. 1 or more years of experience working in a medical or healthcare environment required Responsibilities Experience working with insurance companies and have extensive knowledge of different types of coverage and policies Must have excellent multitasking skills, with the ability to work on many projects at once. Must be very detail-oriented and organized to maintain accurate patient insurance records Must work well with others, as they will work as part of a health care team, striving to provide patients with the best care possible Answer inquiries promptly and in a polite and professional manner Obtain and enter accurate information into the client's system Utilize client system, medical records, and other documents to successfully authorize procedures and medications Answer questions and offer other information, as requested, to provide patient-focused service and a positive impression of the organization Suggests improvements and participates in organized efforts to improve service levels Adheres to all HIPPA policies Act as a liaison for the client, patient, and facilities Understanding of when to escalate situations to Supervisor Contacts insurance companies and patient regarding insurance Communicates with practice via email and written communication regarding coverage Aid team members in maintaining turnaround times as expected from client Account for internal control responsibilities in line with the organization's objectives Ability to handle Protected Health Information in a manner consistent with the Health Insurance Portability and Accountability Act (HIPAA) Other duties as assigned by supervisor or manager Work Environment/Physical Demands/Travel Requirements The role may involve working under pressure to meet tight deadlines, managing conflicting priorities, and adapting to changes in project requirements. 100% onsite

Travel:

None Primarily sedentary, using a computer and phone very often

Job Type:

Full-time Benefits:

401(k) 401(k) matching Dental insurance Disability insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Vision insurance Application Question(s): How many years of Gastro experience do you have? Ability to

Commute:

Louisville, KY 40202 (Required)

Work Location:

In person